2010至2014年北京市通州区剖宫产率及手术指征顺位变化分析

摘要

Objective To investigate the measures to reduce cesarean section rate by analyzing the causes of high cesarean section rate and the change of main indications for cesarean section.Methods Clinical data of 44610 megnonl women hospitalized in Xinhua Hospital of Tongzhou District of Beijing from 2010 to 2014 were analyzed retrospectively.Cesarean section rate and changes of surgical indications rank were recorded.Results The cesarean section rate was 54.47%, 52.33%, 47.74%, 46.67%and 48.40%, respectively, in 5 year, and the difference was not significant among 5 years (χ2 =1.038,P>0.05) .The order of top 5 indications for cesarean section changed.The previous uterine scar gradually rose to be the first surgical indication.The constitution of cesarean section without indications declined overall.Conclusion Perinatal maternal and prenatal health education, strict control of cesarean section indications, and improving the level of medical personnel midwifery are effective measures to reduce cesarean section rate.%目的 通过分析剖宫产率居高不下及剖宫产主要手术指征顺位变化的原因及其主要影响因素,探讨降低剖宫产率的措施.方法 回顾性分析北京市通州区新华医院2010年至2014年住院分娩44610例产妇的临床资料,统计5年间剖宫产率及手术指征顺位变化情况.结果 5年间剖宫产率分别是54.47%、52.33%、47.74%、46.67%、48.40%,5年间比较无显著性差异(χ2=1.038,P>0.05);前5位剖宫产手术指征顺位发生了变化,前次术后子宫瘢痕逐渐上升成为手术指征第1位,无指征剖宫产构成比总体呈下降趋势.结论 围生期对产妇进行健康的产前教育,严格掌握剖宫产手术指征,提高医务人员的助产水平是降低剖宫产率的有效措施.